October 16, 2025

ALR Commission to hold Public Hearing - Wednesday, November 5th from 2:00 to 4:00 pm on Zoom

The Executive Office of Aging & Independence (AGE) and the ALR Commission are asking for support in spreading the word about an upcoming public hearing on Wednesday, November 5th at 2:00 p.m. (via Zoom). The purpose of the hearing is to hear directly from residents, family members, and other stakeholders about their experiences and perspectives on assisted living in Massachusetts. Input will help inform the Commission’s recommendations to the Legislature.

The Commission is seeking input in each of the six key topic areas:

1. Resident rights and protections (e.g., how residents and families can raise concerns, transparency of policies, financial protections)

2. Keeping residents safe in emergencies (e.g., fire safety, disaster planning,       emergency response)

3. Staffing and workforce (e.g., type of staff, staff levels, training)

4. Types and levels of care (e.g., making sure care matches residents’ needs)

5. Affordability and access (e.g., costs for residents and families)

6. Transparency of information for families and residents (e.g., how people can better       compare options and make informed choices)

Assisted Living Residences are encouraged to promote awareness of the upcoming public hearing.  Below are some suggested outreach efforts:

• Share the attached flyer and hearing information with residents and families (via email, newsletter, or other communication channels).

• Post the flyer in a public/common area (e.g., lobby, dining room, or activity board).

• Support residents who may wish to testify by helping them access the Zoom hearing (for example, providing a tablet or computer in a quiet space).

To ensure everyone has an opportunity to speak, oral testimony will be limited to approximately two minutes per person. Written testimony may also be submitted through Friday, November 14th to william.travascio@mass.gov and francis.p.sullivan2@mass.gov.

Please encourage anyone interested to register in advance using this link: https://zoom.us/meeting/register/oncbJk5iRjCJM9AFwnaCbA#/registration

MassHealth to update filing for PNA Accounting

MassHealth has updated the filing system for the annual Personal Needs Allowance accounting for long term care facilities beginning with this year’s filing.  In anticipation of the upcoming changes, facilities must confirm their filer of record to the NFReporting Team to ensure proper access to the new web portal.

MassHealth has provided the NFReporting Team with an initial list of facility filers of record. An email will be sent from NFReporting@umassmed.edu to each listed filer. Individuals who receive the email, must confirm that they are the correct contact or provide updated contact information for their facility. All confirmations or updates should be sent to NFReporting@umassmed.edu. Once you have confirmed the contact information, you or the correct contact will receive two separate emails, one which will contain a username, sign-on instructions, and web portal link and a second which will contain a temporary password.  Please note that there can be multiple users for each facility. It is important that contact confirmation and registration for the new web portal be done as soon as possible to be sure that your facility remains in compliance with the PNA annual accounting requirements.

Information and instructions on how to prepare the annual PNA accounting will be detailed in a forthcoming MassHealth Long-Term Care Bulletin, which will be available online and circulated to facilities.

Bulletin Issued Clarifying Offset Procedures for Non-Payment of Nursing Facility User Fees

The Executive Office of Health and Human Services issued Administrative Bulletin 25-23 regarding Offset Procedures for Non-Payment of Nursing Facility User Fees.  The bulletin clarifies EOHHS procedures for collecting the user fee assessment from nursing facilities that are not compliant with the quarterly user fee payment and form submission requirements in 101 CMR 512.05.  The bulletin updates and supersedes AB-23-01 and applies to all outstanding user fee assessment forms and payments as of October 1, 2025.  

Mass Dept of Family and Medical Leave Issues Update on Taxability of PFML Benefit Payments

The Massachusetts Department of Family and Medical Leave has issued the following update regarding taxability of Paid Family and Medical Leave Benefits:

The IRS has issued new tax guidance that will impact employers in Massachusetts. Starting on January 1, 2026, DFML and employers participating in state-run Paid Family and Medical Leave (PFML) programs must comply with new IRS tax and reporting requirements.

• Certain portions of medical leave benefits will be treated like third-party sick       pay (wages) starting on January 1, 2026.

• Employers who are required to pay medical leave contributions will be responsible for remitting the employer share of FICA (Social Security and Medicare) and FUTA (federal unemployment) taxes on certain medical leave benefit payments made to employees on or after January 1, 2026. These employers will also be responsible for reporting the taxable portion of medical leave benefits on the employee’s W-2. 

• DFML will provide employers with a Daily Sick Pay Report in the employer portal, which will include the amount of medical leave payments and taxes withheld. DFML does not determine an employer’s tax liability, but the information provided on the Daily Sick Pay Report will be sufficient to transfer to the employer any tax liability incurred as a result of any benefits being considered taxable third-party sick pay and wages by the IRS.

  • Employers must have access to the employer portal in order to receive this important tax-related information. Employers should also ensure that their payroll team, and the appropriate personnel or entities, have access to the employer portal. Learn how to create a Leave Administrator account on the employer portal.

• Employees may choose whether to have state and federal income taxes withheld on       medical and family leave benefits.

• There is no change in the treatment of family leave benefits. These benefits will be reported to employees and the IRS on Form 1099-G.

Massachusetts employers should read the full memo for important information and details.

You can visit our webpage PFML Tax Information for Employers to learn more.

If employees would like to learn more, please refer them to this webpage about Taxes on Paid Family and Medical Leave (PFML) benefits.

Updates on CMS’ Claims Hold

CMS announced in an October 15 Medicare Learning Network (MLN) post that it has instructed the Medicare Administrative Contractors (MACs) to continue to temporarily hold claims dated for October 1, 2025, and later, “for services impacted by the expired Medicare legislative payment provisions passed under the Full-Year Continuing Appropriations and Extensions Act, 2025.  According to the October 15 MLN update, the hold “includes claims paid under the Medicare Physician Fee Schedule, ground ambulance transport claims, and all Federally Qualified Health Center claims. Providers may continue to submit these claims, but payment will not be released until the hold is lifted.”

CMS also posted on its All Fee-For-Service Providers Spotlight Page that “In light of the continuing government shutdown, CMS will continue to process and pay held claims in a timely manner with the exception of select claims for services impacted by the expired provisions [emphasis added]. To date, no payments have been delayed as statute already requires all claims to be held for a minimum of fourteen days, and this recent hold is consistent with that statutory requirement. Providers may continue to submit claims accordingly.”

As explained  in an October 10 LeadingAge update, the hold was put in place to avoid the reprocessing of claims for services that had been temporarily extended but expired on October 1, such as telehealth, in the event that such services can resumes.

CMS warns, on the All Fee-For-Service Providers Spotlight Page, “Absent Congressional action, beginning October 1, 2025, many of the statutory limitations that were in place for Medicare telehealth services prior to the COVID-19 Public Health Emergency took effect again for services that are not behavioral health services. These include prohibition of many services provided to beneficiaries in their homes and outside of rural areas, and hospice recertifications that require a face-to-face encounter. In the absence of Congressional action, practitioners who choose to perform telehealth services that are not payable by Medicare on or after October 1, 2025, may want to evaluate providing beneficiaries with an Advance Beneficiary Notice of Noncoverage (ABN).” The spotlight points providers to further information on use of the ABN, including ABN forms and form instructions, here.

CMS recommends practitioners monitor Congressional action and says practitioners may choose to hold claims associated with telehealth services that are not payable by Medicare in the absence of Congressional action and points to additional information here. 

Providers can review the full list of health provisions that have expired or are scheduled to expire in 2025 or 2026 here.

Read the CMS October 15 MLN Connects Newsletter here. Read the CMS All Fee-For-Service Providers Spotlight Page here.

TEAM Bundles and SNFs’ Eligibility for 3-Day Stay Waiver

The Medicare Learning Network has published detailed guidance on how hospitals participating in the new bundled payment model called Transforming Episode Accountability Model (TEAM) can use a waiver from the Skilled Nursing Facility (SNF) 3-day stay requirements. First, a little background on TEAM. The TEAM is the new bundled payment program that begins January 1, 2026. Hospitals in designated core-based statistical areas (CBSAs) are mandated participants, but hospitals outside of the required CBSAs, can opt in to participate. This optional participation is most likely in cases where hospitals participated in previous bundled payment models like the Bundled Payment for Care Improvement - Advanced model (BPCI-A), which is scheduled to end December 31, 2025, or the Comprehensive Joint Replacement model (CJR), which ended in 2024.  And only Medicare FFS beneficiaries can be covered under TEAM. TEAM only applies to the following procedures and therefore the 3-day stay waiver could only apply for these situations not all hospitalizations: Lower extremity joint replacements, surgical hip femur fracture treatment, spinal fusion, Coronary artery bypass graft and major bowel procedure. As for the MLN memo, here is what is important to know:

·      Hospitals are permitted but not required to use the 3-day stay waiver they have been given under the model

·      If they opt to use the waiver, it only applies to patients eligible to be covered by TEAM and the admission must be within 30 days of the discharge.

·      The waiver can only be used for “qualified SNFs” which is defined as a SNF that has had a 3-star or higher rating for at least 7 of the last 12 months (see p. 5 of the memo). Swing beds providing SNF services are exempt from the 3-star or higher rating requirement.

·      Qualifying SNFs must include the proper code for a TEAM waiver to be eligible. 

Members are encourage to review all the details in the MLN memo to determine its impact on their SNF. 

Rescheduling HUD Northeast Region Call with LeadingAge Members

Due to the government shut down, the HUD Northeast Region Call with LeadingAge members, originally scheduled for October 21st will be rescheduled.  As soon as we have a new date available we will let members know.

NASHP Releases Toolkit for Providers to Support Family Caregivers

On October 8, the National Academy for State Health Policy released a practical resource for community partners, providers, and advocates who support family caregivers. The toolkit includes materials to raise awareness and connect caregivers to services via sample messaging, and ready to use templates. Materials are able to be customized to your organizations branding and unique needs. Explore the resources and toolkit here. 

New Toolkit: Bridging the Digital Divide for Older Adults

The Executive Office of Aging and Independence (AGE) has launched the Enhancing Digital Literacy for Older Adults (EDLOA) Playbook .   This new toolkit highlights lessons learned from 24 community programs  across Massachusetts that empowered thousands of older adults with devices,  training, and confidence to thrive in today’s digital world. The Playbook  includes practical strategies, case studies, and ready-to-use resources to  spark or strengthen your organization’s own digital equity work.

Learn more and access the playbook here.  

Sign up for LeadingAge’s Free Weekly National Policy Pulse Calls

Join more than 1000 of your LeadingAge peers for our National Policy Pulse calls where we keep members equipped to navigate the ever-evolving landscape of aging services national policy.  The calls are on Mondays at 3:30 p.m. ET. If you’re interested in signing up for these members-only calls, please sign up using the link on our National Policy Pulse webpage.

Weekly Recaps

Miss any news from last week? Check out LeadingAge’s weekly recaps:

• Affordable Housing Weekly Recap

• Home Health Weekly Recap

• Hospice Weekly Recap

• Life Plan Community Weekly Recap

• Medicaid, HCBS, and PACE Weekly Recap

• Nursing Home Weekly Recap

• Workforce Policy Weekly Recap